Cardiac tumor with simultaneous embolization to the heart and brain: Presenting with acute myocardial infarction and cerebral infarction

This report describes a 60 years old hypertensive and diabetic woman presenting with acute anterior myocardial infarction accompanied by electrocardiographic changes and raised cardiac enzymes. Her coronary angiography revealed a distal left anterior descending artery block; but at this stage the patient rapidly developed unconsciousness with loss of movement in all 4 limbs. Magnetic resonance imaging of the brain revealed massive multiple bilateral infarcts and transthoracic echocardiography subsequently done demonstrated a large mobile mass in the left atrium that prolapsed into the mitral annulus. This mass was heterogeneous with a satellite nodule. The patient had to be shifted to the intensive care unit where she initially required endotracheal intubation and temporary mechanical ventilation. The patient continues to be in coma and is being managed conservatively in the intensive care unit as the attendant refused to give consent for surgical removal of the left atrial tumor. There are less than a handful case report narrating simultaneous acute anterior myocardial and bilateral large cerebral infarctions subsequent to embolization from a probable left atrial myxoma.